Provider Demographics
NPI:1568763480
Name:LOMBARD, KIMBERLY (MS, RD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:LOMBARD
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N PATTERSON RD
Mailing Address - Street 2:PO BOX 75
Mailing Address - City:REED CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49677-8041
Mailing Address - Country:US
Mailing Address - Phone:231-832-4812
Mailing Address - Fax:231-832-4072
Practice Address - Street 1:300 N PATTERSON
Practice Address - Street 2:SPECTRUM HEALTH REED CITY HOSPITAL
Practice Address - City:REED CITY
Practice Address - State:MI
Practice Address - Zip Code:48850-8041
Practice Address - Country:US
Practice Address - Phone:231-832-4812
Practice Address - Fax:231-832-4072
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL726487133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered